6.  The applicant was born in 1973 and lives in the town of Oryol.
7.  On 14 February 1997 the applicant was arrested on suspicion of manslaughter. He was allegedly severely beaten up after police officers took him to a police station.
8.  On 31 October 1997 the Sovetskiy District Court of the Oryol Region found the applicant guilty of murder and sentenced him to twelve years’ imprisonment. The judgment was upheld on appeal and became final on 16 December 1997. Ten days later the applicant was sent to serve his sentence in correctional colony no. 2, Oryol Region.
9.  Relying on a copy of the applicant’s medical record and certificates issued in December 2007 by the acting head of temporary detention facility no. IZ-57/1 in Oryol (“facility no. 1”), the Government argued that on 25  February 1997, on admission to facility no. 1, the applicant had undergone  a chest fluorography examination, which revealed no signs of tuberculosis. The Government further submitted that every six months the applicant had been examined by medical specialists and had been subjected to chest fluorography examinations for the purpose of tuberculosis screening. The examinations revealed no presence of the illness. As follows from the list of X-ray examinations enclosed with the applicant’s medical record, between March 1997 and 30 October 2001 the applicant received seven fluorography examinations. The authorities had fully complied with the schedule of one exam every six months at the beginning of the applicant’s detention. However, almost a year passed between the chest fluorography examinations in 2000 and 2001.
10.  On 29 October 1998 a tuberculosis specialist at correctional colony no. 2 made the following entry in the applicant’s medical record:
“[The applicant] is assigned to the 4th [group] of tuberculosis regular medical supervision as [he] has been in contact with inmate A. who suffers from tuberculosis...
[The applicant is prescribed] izoniazid 0.6 [mg] once,... [multivitamins] [and] diet for two months.”
The applicant’s medical history (record no. 3607/415) drawn up in the tuberculosis hospital of facility no. 1 identified the applicant’s detention with inmate A. in October 1998 as the cause of his tuberculosis.
11.  According to the applicant, in September 2000 he had been detained for several days in a punishment cell with an inmate, Mr Ye., who was suffering from an active form of tuberculosis. Mr Ye. had been constantly coughing up blood. The applicant’s requests for a transfer to another cell received no response from the colony administration. Soon after release from the punishment cell the applicant had fallen ill. However, his numerous complaints to the colony medical division had been to no avail. Relying on a certificate issued by the Oryol Regional police department, the applicant further argued that in March 2001 Mr Ye. had died from tuberculosis. The Government averred that the applicant had never been detained with the late Mr Ye. However, he had been detained with a person bearing the same last name as Mr Ye. The applicant’s cellmate at the time had not been suffering from an active form of tuberculosis and therefore had not presented a danger to other detainees.
12.  On 30 October 2001 the applicant was once again subjected to a fluorography examination, which detected tuberculosis changes in the form of dense foci and local fibrosis in his left lung.
13.  According to the Government, on 15 November 2001 the applicant was transferred to the tuberculosis hospital in facility no. 1 for treatment. However, it appears from the applicant’s medical record and certificates issued by the acting head of facility no. 1 and the director of correctional colony no. 2, it was not until 7 December 2001 that the applicant was admitted to the facility’s tuberculosis hospital. Following a number of tests doctors diagnosed the applicant with “focal pulmonary tuberculosis, [type] 1A, [smear-negative results for] mycobacterium tuberculosis (“MBT”)”. Between 17 December 2001 and 14 February 2002 the applicant was subjected to an intensive chemotherapy regimen, comprising a number of drugs: isoniazid, rifampicin, ethambutol and tisamid. During the initial stage of the treatment the applicant adhered to a strict medication regime and received sixty doses of anti-bacteriological medicines. On 15 February 2002 the continuation phase of the therapy commenced, comprising treatment with 120 doses of isoniazid and rifampicin (“HR regimen”). The chemotherapy regimen was accompanied by pathogenetic and general health-improving therapy with a daily special dietary food ration. The intake of every dose was observed by the hospital staff. As follows from the applicant’s medical record, clinical blood and urine analyses, sputum monitoring, as well as regular chest radiography examinations, were conducted regularly during the applicant’s treatment in the hospital.
14.  On 26 June 2002 the applicant was discharged from the tuberculosis hospital with a final diagnosis of “focal tuberculosis of the left lung in the resolution phase” and recommendations to continue treatment with isoniazid and ethambutol (“HE regimen”) accompanied by a daily special dietary food ration. The doctors also indicated that the next X-ray examination should be carried out within three months and that clinical blood and urine analysis and sputum monitoring should be performed once in three months.
15.  Between 27 June and 25 October 2002 the applicant was detained in correctional colony no. 2. His medical record shows that on 28 June 2002 the colony doctor made a note that the applicant was to receive special dietary food. On 9 October 2002 the applicant was examined for the first time by a colony doctor, who once again confirmed that the applicant was suffering from focal tuberculosis of the left lung. The doctor authorised a chest X-ray exam and sputum testing. On 22 October 2002 the applicant was sent to Oryol town tuberculosis hospital to undergo prescribed examinations.
16.  On 31 October 2002, having studied the applicant’s medical records, including the results of an X-ray examination and the three sputum smear tests performed in October 2002, a medical panel comprising a number of medical specialists took into account the positive dynamic of the applicant’s treatment and issued the following diagnosis: “focal tuberculosis of the upper lobe of the left lung in the resolution and consolidation phase,... (fading of the tuberculosis process)”. On 18 November 2002 the applicant was transferred back to correctional colony no. 2 with a recommendation to continue outpatient treatment on a two-month HE regimen twice a year.
17.  During his first medical examination in the colony on 13 January 2003 the applicant complained of fatigue and headache. A chest fluorography exam performed on 5 February 2003 revealed singular small residual patches in the upper lobe of the applicant’s left lung. In early March 2003 the applicant was prescribed prophylactic treatment with isoniazid and ethambutol. A subsequent chest fluorography exam, on 29 April 2003, showed numerous firm patches in the left lung. The colony tuberculosis specialist made an entry in the applicant’s medical record, noting no reason to amend his diagnosis. A subsequent X-ray exam, on 21 July 2003, led to the applicant being diagnosed with “local fibrosis in the upper lobe of the left lung [and] small firm patches”. A month later a colony tuberculosis specialist examined the applicant, recording the absence of complaints and authorising another course of prophylactic treatment on an HE regimen starting from 1 September 2003. Clinical blood and urine tests and a chest fluorography exam performed on completion of the treatment confirmed the diagnosis made on 21 July 2003.
18.  In December 2003 colony medical staff developed a schedule showing future medical procedures and their frequency. In particular, the applicant was to undergo a fluorography examination once in three months and to be subjected to blood, urine and smear testing twice a year. The resumption of the prophylactic treatment on an HE regimen every six months was also recommended. That schedule was upheld on 27 February 2004 by a special tuberculosis medical panel which, having studied the applicant’s medical records, issued the following diagnosis: “clinical recovery from pulmonary tuberculosis accompanied by residual changes in the form of firm foci in the upper lobe of the left lung”.
19.  In the beginning of March 2004 the applicant became extremely ill. A chest fluorography exam carried out on 23 March 2004 showed that he had a left-sided spontaneous pneumothorax. On 27 March 2004 the applicant was admitted to the tuberculosis hospital in facility no. 1 in Oryol. On the basis of another X-ray exam, which showed that the applicant had suffered a complete collapse of the left lung and in view of his complaints of severe chest pain and dyspnea (breathlessness) at rest, on 29 March 2004 he was transferred to the surgical department of the Oryol Regional Tuberculosis Hospital where he was immediately subjected to a chest tube drainage of the left pleural cavity. On 13 April 2004, after an X-ray confirmed the re-expansion of the left lung, the chest tube was removed and the applicant was discharged from the Regional Hospital to the tuberculosis hospital in facility no. 1. The discharge was effected with a recommendation that the applicant undergo an intensive two-month chemotherapy regimen with four drugs: isoniazid, rifampicin, pyrazinamide and ethambutol (“2 HRZE regimen”). The applicant remained in the facility tuberculosis hospital until 6 May 2004. A prescription certificate attached to the applicant’s medical record shows that he received four anti-bacteriological medicines between 14 April and 6 May 2004.
20.  On 19 May 2004 the applicant arrived in correctional colony no. 2. When he was admitted a colony doctor made the following entry in the applicant’s medical record: “arrived from [the tuberculosis hospital of facility no. 1] in Oryol with diagnosis of clinical recovery from pulmonary tuberculosis accompanied by residual changes in the form of firm foci in the upper lobe of the left lung. Prophylactic treatment [is to be carried out] twice a year for two months, [and] an X-ray examination [and] clinical blood and urine tests [are to be performed] twice a year. Diet food ration until 1 June 2005”.
21.  It appears from the applicant’s medical record that the schedule of X-ray examinations and clinical testing was fully complied with. However, in August 2004 the applicant lodged a complaint with the Prosecutor General’s office alleging inadequate medical assistance. The complaint was readdressed to the Oryol Regional Prosecutor. No response followed.
22.  The applicant’s medical history contained a number of entries made by attending tuberculosis specialists, recording the applicant’s negative attitude towards the treatment. In particular, on 1 September 2004 the colony doctor reported the applicant’s refusal to take a two-month prophylactic course of anti-bacteriological drugs. In February 2005 the colony medical staff recorded the applicant’s refusals to submit to an X-ray examination and blood, urine and sputum tests. It was also noted that the applicant did not want to confirm his refusals in writing. Numerous further attempts in March and April 2005 by the colony medical staff to persuade the applicant to submit to medical procedures and to undergo prophylactic treatment were unsuccessful. On 28 June 2005 the applicant was summoned to the colony medical unit where, in the presence of the director of the correctional colony and representatives of the Moscow Human Rights Commission, it was once again explained to him that it was necessary to continue treatment and undergo medical examinations, and he was warned that a relapse was possible. The applicant wrote a statement that he was willing to submit to medical examinations and treatment, on condition that he was admitted to the tuberculosis hospital of facility no. 1 for examinations by independent medical specialists invited by his relatives. When two days later the applicant was made an offer to be sent to Livny Town Hospital he refused it.
23.  Early in August 2005 the applicant applied to Livny District Court seeking to be released on parole on health grounds. In particular, the applicant argued that his tuberculosis and the absence of effective treatment made him eligible for release. On 5 August 2005 the District Court stayed the proceedings so that a thorough medical examination of the applicant could be carried out. The examination was to be performed in the tuberculosis hospital in facility no. 1.
24.  Between 20 and 25 August 2005 the applicant underwent medical examinations, including an X-ray exam and clinical blood analysis, in the tuberculosis hospital in facility no. 1. He, refused however to submit to urine and sputum smear and culture testing and to undergo an electrocardiogram, citing “personal considerations”. Having observed no pathology, the hospital doctors confirmed the applicant’s previous diagnosis of clinical recovery from tuberculosis and declared that he was fit to continue serving his sentence in the correctional colony.
25.  On 9 February 2006 the District Court dismissed the applicant’s request for release, relying on the results of the applicant’s medical examination in August 2005 and finding that the applicant’s health did not preclude him from serving the sentence. The applicant did not appeal.
26.  All entries made by attending doctors in the applicant’s medical history between 1 September 2005 and February 2007 recorded that he was refusing to undergo seasonal tuberculosis treatment and/or to submit to medical observations and testing. For instance, on 14 April 2006 the applicant was visited by a representative of the Medical Department of the Oryol Regional Service for Execution of Sentences. The visit was carried out in response to a complaint from the applicant’s mother about the authorities’ alleged failure to provide the applicant with effective medical assistance. The applicant firmly refused to talk to the representative and protested that he did not wish to have any such contact in the future. In May 2006 the head of the medical department of the correctional colony, assisted by a physician from the Human Rights Committee, examined the applicant. The latter complained of shortness of breath, fatigue, dizziness and excessive perspiration. An X-ray examination did not reveal any changes in the lungs. The applicant refused a request that he submit to additional clinical examinations. His refusals were attested to by written statements of at least two members of the colony medical staff.
27.  In August 2007 the director of correctional colony no. 2 lodged an application with the Livny District Court of the Oryol Region requesting that the applicant be compulsorily admitted to Special Medical Tuberculosis Establishment no. 3 in the Tula Region for an in-depth medical examination and prophylactic treatment for tuberculosis. The colony director argued that since August 2004 the applicant had on a number of occasions refused to submit to prophylactic and clinical examinations, which violated sanitary and anti-epidemic regulations. The applicant’s refusals made it impossible for the colony medical personnel to observe the dynamic development of the illness and to effectively control and treat it if necessary. The colony director insisted that the applicant’s behaviour presented a danger to a large number of detainees and colony staff members who were in contact with the applicant.
28.  The applicant and his representatives objected, arguing that the District Court lacked jurisdiction to authorise the applicant’s admission to a hospital against his will, as he did not suffer from the contagious form of tuberculosis. In any event, the applicant was ready to submit to medical observations if they were to be carried out by specialists from medical establishments other than those in correctional colony no. 2 or detention facility no. 1. He insisted that the medical assistance afforded to him in those two facilities had been inadequate and ineffective.
29.  On 14 August 2007 the District Court adjourned the proceedings, having authorised a forensic medical examination of the applicant by specialists from the Oryol Regional Forensic Medical Expert Bureau to determine the form of tuberculosis from which the applicant suffered. The District Court held, in so far as relevant, as follows:
“By virtue of Article 10 § 2 of the Russian law “On Prevention of Dissemination of Tuberculosis in the Russian Federation” individuals suffering from contagious forms of tuberculosis who... intentionally avoid medical examinations aimed at detecting tuberculosis, or avoid treating it, shall be admitted, by court decision, to specialised medical anti-tuberculosis establishments for mandatory examinations and treatment.
By virtue of Article 18 § 3 of the Russian Penitentiary Code individuals sentenced to imprisonment who are suffering from contagious forms of tuberculosis shall be admitted for mandatory treatment by the detention facility administration following a decision by a medical panel.
The case file materials do not contain any information on the form of tuberculosis from which [the applicant] is suffering... The colony representative also did not provide such information in court hearings. The court therefore considers that special knowledge in the field of medicine is required for the correct decision in the present case, and that it is necessary to perform a complex forensic medical examination to determine the state of [the applicant’s] health”.
30.  On 11 September 2007 the applicant was transferred to facility no. 1 to receive the expert examination. He was sent back to the correctional colony on 19 October 2007. On 25 September 2007 the Expert Bureau issued a report, noting that it was impossible to determine the form of tuberculosis from which the applicant was suffering because of the latter’s refusal to submit to medical examinations, and given the absence of any recent information in the applicant’s medical record describing the state of his health. On 20 December 2007 the Livny District Court, finding that in 2006 and 2007 the applicant had repeatedly refused to undergo medical examinations, testing and seasonal prophylactic treatment and that the possibility of a relapse could thus not be excluded, ordered the applicant’s placement in Special Medical Tuberculosis Establishment no. 3 in the Tula Region. That decision was upheld on appeal by the Oryol Regional Court on 13 February 2008.
31.  The applicant’s medical record shows that while detained in the correctional colony between 19 October and 28 December 2007 the applicant continued refusing to submit to medical examination, X-ray exams, clinical testing and seasonal prophylactic treatment. Each time, in response to the applicant’s refusal, colony staff members drew up reports recording the refusal and describing the applicant’s behaviour.
32.  The most recent medical certificate, dated 28 December 2007, issued in correctional colony no. 2 and submitted to the Court by the Government, reads as follows:
“[The applicant’s skin and visible mucous membrane are clean. Normosthenic [athletic] type; satisfactory nutrition; the osteoarticular skeleton is without deformations; movements are entirely preserved. [The applicant] refused to submit to an objective examination (palpation, percussion, auscultation, anthropometric measuring). [He] has no complaints; the state of his health is satisfactory. At present [his] diagnosis is: clinical recovery from pulmonary tuberculosis, [Supervision Group Type] 3 until February 2007; the tuberculosis control was not cancelled as [he] is refusing to undergo medical examinations and treatment.”
33.  In the meantime, in 2007 the applicant lodged an action against the Russian Ministry of Justice, the Oryol Regional Service for Execution of Sentences and correctional colony no. 2, seeking, inter alia, compensation for damage caused to his health as a result of his having contracted tuberculosis in detention and inability to receive effective medical assistance.
34.  On 3 June 2008 the Livny District Court dismissed the applicant’s claim for damages, finding no evidence of fault in the authorities’ actions and no causal link between their actions and the damage caused to the applicant’s health as a result of his having contracted tuberculosis. While issuing the judgment, the District Court rejected as unreliable statements by a number of applicant’s former inmates, who had argued in open court that inmates suffering from contagious forms of tuberculosis had frequently been detained with healthy inmates in correctional colony no. 2 and that many of them had contracted tuberculosis during their detention in that facility. The District Court’s judgment became final on 17 September 2008 when the Oryol Regional Court upheld it on appeal.
35.  The applicant was released in 2009, having served his entire sentence.